Apparatus and method for external beam radiation distribution mapping

ABSTRACT

An apparatus and method for in vivo and ex vivo control, detection and measurement of radiation in therapy, diagnostics, and related applications accomplished through scintillating fiber detection. One example includes scintillating fibers placed along a delivery guide such as a catheter for measuring applied radiation levels during radiotherapy treatments, sensing locations of a radiation source, or providing feedback of sensed radiation. Another option is to place the fibers into a positioning device such as a balloon, or otherwise in the field of the radiation delivery. The scintillating fibers provide light output levels correlating to the levels of radiation striking the fibers and comparative measurement between fibers can be used for more extensive dose mapping. Adjustments to a radiation treatment may be made as needed based on actual and measured applied dosages as determined by the fiber detectors. Characteristics of a radiation source may also be measured using scintillating materials.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation application of U.S. patentapplication Ser. No. 12/841,891, filed Jul. 22, 2010, which is acontinuation-in-part application of U.S. patent application Ser. No.12/647,920 filed on Dec. 28, 2009 now issued as U.S. Pat. No. 8,133,167,which is a continuation of U.S. patent application Ser. No. 11/293,161filed on Dec. 5, 2005 now issued as U.S. Pat. No. 7,662,083, thedisclosures of which are incorporated by reference herein in theirentirety.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The invention relates generally to detecting radiation levels inradiation therapy and, more particularly, to an apparatus and method fordetecting, measuring and altering dosage levels in external beamradiation treatments.

2. Related Art

External beam radiation modalities are the most common treatment andimaging tools for cancer management. In external beam radiationmodalities, a beam consisting of photons, electrons or heavier particles(protons are ions) are used to either treat or image cancer tumors.External beam radiation modalities may be used for a wide range ofdiseases, including, for example, cancer tumors (localized or notlocalized), assessment of bone structures, and visualization of objectswithin a body or similar conditions.

Using prostate cancer as an example, there are currently three types ofexternal beam radiation modalities suitable for treating prostatecancer: photon irradiation, proton irradiation and ions irradiation.Each offering various advantages with respect to each other. The patientusually lays on a bed for this treatment and undergoes a two-stageprocess: an imaging step to assess the location and size of the tumorand a treatment step to eliminate the cancer cells. The first step isprimarily performed through the use of photons via X-ray or computerizedtomography (CT) scans.

Currently, only post-irradiation techniques are used to provide a crudeassessment of the dose delivered to patient in external beam therapy.Recent clinical studies also indicate that some cancers may be causedduring the imaging process. There is currently no method for measuringthe real-time multi-dimensional tissue dose distribution. Instead,tissue density mapping may be obtained from magnetic resonance imagingand x-ray computed tomography. These tissue density maps are oftenutilized in combination with the total beam fluency, beam positions andirradiation times, in Monte Carlo simulations to calculate the dosedistribution in tissue. However, relying on simulations does not provideany actual measured dose distribution and therefore any over or underexposure is typically determined post therapy by the physiologicalresponse. Without ability to measure actual dosage distribution duringexternal beam radiation modalities, adjustments of the dose distributioncannot be made during treatments so that a more desired effect can beachieved such as assuring more effective targeting of tumors, oravoiding/minimizing irradiation of nearby healthy tissue.

Accordingly, there is a need to be able to characterize the radiationbeam to aid in creating an external beam radiation treatment plan basedon the characterized beam radiation source. Furthermore, there is a needto a have a way to measure actual radiation dosages delivered inexternal beam radiation modalities when using the characterized beamradiation source to determine tissue dosimetry so that a way of alteringthe treatment plan, based on the actual measurements, might be achieved.In this way, a desired dosage level and distribution of radiation mightbe more accurately delivered during the course of treatment.

SUMMARY OF THE INVENTION

The invention satisfies the foregoing needs and avoids the drawbacks andlimitations of the prior art by providing an apparatus, system andmethods for the characterization of radiation sources used in radiationtherapy and imaging and for detecting, measuring and altering dosagelevels during treatments and imaging procedures. In particular, theinvention provides for in vivo and ex vivo control, detection andmeasurements of radiation using scintillating materials.

Accordingly, in one aspect of the invention an active delivery ormeasuring guide, which may be a catheter or other suitable device, isprovided. The active measuring guide includes a receptacle for receivinga source of radiation or a radiation beam and at least one radiationdetector, including scintillating material, emitting a light level inproportion to sensed incident levels of radiation.

In another aspect of the invention, a system for monitoringbrachytherapy or external beam radiation is provided. The systemincludes a radiation sensing device, which again may be a catheter orother device, having a receptacle for receiving a radiation source or aradiation beam, a photo sensor, such as a photomultiplier, connected tothe sensing device and a delivery system connected to the sensingdevice. The delivery system moves a radiation source or a radiation beamin the sensing device according to a pre-determined plan and the sensingdevice is configurable for use with the delivery system.

According to another aspect of the invention, a method forcharacterizing a radiation source or radiation beam for use in radiationtherapy or imaging is provided. The method includes the steps of movingat least one of a therapeutic radiation source or radiation beam and aradiation detector in relation to the other, measuring radiationcharacteristics of the radiation source or radiation beam, and recordingthe measured radiation characteristics and associating the measuredradiation characteristics with the radiation source or radiation beam.Further, the invention may provide a radiation source or radiation beamcharacterized by this process.

In another aspect of the invention, a method for detecting radiation inbrachytherapy or from an external delivery system is provided. Themethod includes the steps of inserting a radiation source into adelivery guide and/or measuring a level of radiation emitted by aradiation source or radiation beam by detecting light emitted by theactive delivery guide or measuring device.

In yet another aspect of the invention, a radiation detector for use inbrachytherapy or external beam radiation is provided. The radiationdetector includes scintillating material responsive to radiation andconfigured to be coupled to a photo detector, wherein the scintillatingmaterial is implantable in a biological body and the photo detectordetects light levels emitted by the scintillating material and providesoutputs indicative of radiation levels detected by said scintillatingmaterial.

In another aspect, a radiation detector is provided including a catheterhaving an opening at a first end, and at least one balloon portioncoupled to the catheter proximate a second end, wherein the at least oneballoon portion includes scintillating material arranged along a surfaceof the balloon portion, the scintillating material configured to becoupled to a photo detector, for detecting incident levels of radiationin a balloon-related procedure or for adjusting a treatment plan basedon the detected level of radiation.

In another aspect, a radiation detector is provided that includes afirst set of scintillating fibers, and a second set of scintillatingfibers arranged at an angle to the first set of scintillating fibers,wherein at least one first signal from the first set of scintillatingfibers and at least one second signal from the second set ofscintillating fibers provide an indication of detected levels ofincident radiation, a location of the radiation being associated withthe intersection of respective first set of scintillating fibers andsecond set of scintillating fibers producing the respective detected atleast one first signal and at least one second signal for adjusting atreatment plan based on the detected level of radiation.

In still another aspect, a method for tracking beam particles isprovided that includes providing a first set of scintillating fibers andproviding a second set of scintillating fibers arranged at an angle tothe first set of scintillating fibers, wherein at least one first signalfrom the first set of scintillating fibers and at least one secondsignal from the second set of scintillating fibers provide an indicationof detected levels of radiation, a location of the detected radiationbeing associated with the intersection of respective first set ofscintillating fibers and second set of scintillating fibers producingthe respective detected at least one first signal and at least onesecond signal for tracking a beam of the radiation.

In another aspect, a radiation detector is provided that includes atleast one positioning device having at least one expandable portion foruse in therapy or diagnostic procedures and scintillating material,wherein the at least one positioning device includes the scintillatingmaterial arranged along a wall of the at least one expandable portion,the scintillating material configured to be coupled to a photo detectorfor detecting incident levels of radiation in the balloon-assistedprocedure.

In another aspect, a radiation detection is provided including at leastone fiber configured with scintillating material along at least aportion of the length of the at least one fiber or configured withscintillating material proximate an end of the at least one fiber,wherein the at least one fiber is positionable to maintain respectivescintillating material at a measurement location, and wherein the atleast one fiber is configured to be coupled to a photo detector fordetecting and measuring incident radiation.

In another aspect, a method for radiation detection is provided thatincludes providing at least one fiber configured with scintillatingmaterial along at least a portion of the length of the at least onefiber or configured with scintillating material proximate an end of theat least one fiber, wherein the at least one fiber is positionable tomaintain respective scintillating material at a measurement location,and coupling the at least one fiber to a photo detector for detectingand measuring incident radiation at the at least one fiber for alteringa treatment plan based on the detected and measured incident radiation.

Additional features, advantages, and embodiments of the invention may beset forth or apparent from consideration of the following detaileddescription, drawings, and claims. Moreover, it is to be understood thatboth the foregoing summary of the invention and the following detaileddescription are exemplary and intended to provide further explanationwithout limiting the scope of the invention as claimed.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are included to provide a furtherunderstanding of the invention, are incorporated in and constitute apart of this specification, illustrate embodiments of the invention andtogether with the detailed description serve to explain the principlesof the invention. No attempt is made to show structural details of theinvention in more detail than may be necessary for a fundamentalunderstanding of the invention and the various ways in which it may bepracticed. In the drawings:

FIG. 1 is a functional block diagram of an apparatus for characterizingradiation sources, constructed according to principles of the invention;

FIGS. 2A and 2B are schematic diagrams showing embodiments of activecatheters, according to principles of the invention;

FIGS. 2C and 2D are schematic diagrams showing embodiments of radiationdetectors, constructed according to principles of the invention, withFIG. 2C showing the detector constructed as a scintillating fiber withan optional housing, and FIG. 2D showing the detector made of solid,liquid, or gaseous scintillating material;

FIG. 2E is a schematic diagram of another radiation detector of theinvention having scintillating material at its tip and its use incharacterizing a radiation source;

FIG. 2F is an illustration of the radiation detector of FIG. 2E beingused to detect radiation in vivo, according to principles of theinvention;

FIG. 3 is schematic diagram showing an illustrative example of use of anactive catheter of the invention in a biological system, according toprinciples of the invention;

FIG. 4 is a schematic diagram showing an illustrative example of use ofa plurality of active catheters of the invention for treating a tumor,according to principles of the invention;

FIGS. 5A-5F are graphs, each graph being illustratively representativeof radiation detected by a separate active catheter of the inventionfrom among six active catheters employed during a radiation therapytreatment, according to principles of the invention;

FIG. 6A is a schematic diagram of an active mammosite catheterconstructed according to the principles of the invention;

FIG. 6B is a schematic diagram showing an illustrative example use of anactive mammosite catheter, according to principles of the invention;

FIG. 7 is a flow diagram of an embodiment showing process steps of usingan embodiment of the invention;

FIG. 8 is a diagram of an embodiment for external beam qualityassurance, configured according to principles of the invention;

FIG. 9A is an illustration of a radiation detector scheme configured topermit determination of a dose, configured according to principles ofthe invention;

FIG. 9B is an illustration of an embodiment of a radiation detectorconfigured to permit determination of a radiation dose or to mapradiation, according to principles of the invention;

FIG. 10 is an exemplary schematic of a positioning balloon with one ormore scintillating fibers as an in-vivo or ex-vivo dosimetry for qualitymonitoring, according to principles of the invention;

FIG. 11A is an exemplary embodiment of a flexible radiation detector,configured according to principles of the invention; and

FIG. 11B is an exemplary embodiment of a flexible radiation detector,configured according to principles of the invention;

DETAILED DESCRIPTION OF THE INVENTION

The embodiments of the invention and the various features andadvantageous details thereof are explained more fully with reference tothe non-limiting embodiments and examples that are described and/orillustrated in the accompanying drawings and detailed in the followingdescription. It should be noted that the features illustrated in thedrawings are not necessarily drawn to scale, and features of oneembodiment may be employed with other embodiments as the skilled artisanwould recognize, even if not explicitly stated herein. Descriptions ofwell-known components and processing techniques may be omitted so as tonot unnecessarily obscure the embodiments of the invention. The examplesused herein are intended merely to facilitate an understanding of waysin which the invention may be practiced and to further enable those ofskill in the art to practice the embodiments of the invention.Accordingly, the examples and embodiments herein should not be construedas limiting the scope of the invention, which is defined solely by theappended claims and applicable law. Moreover, it is noted that likereference numerals represent similar parts throughout the several viewsof the drawings.

It is understood that the invention is not limited to the particularmethodology, protocols, devices, apparatus, materials, applications,etc., described herein, as these may vary. It is also to be understoodthat the terminology used herein is used for the purpose of describingparticular embodiments only, and is not intended to limit the scope ofthe invention. It must be noted that as used herein and in the appendedclaims, the singular forms “a,” “an,” and “the” include plural referenceunless the context clearly dictates otherwise.

Unless defined otherwise, all technical and scientific terms used hereinhave the same meanings as commonly understood by one of ordinary skillin the art to which this invention belongs. Preferred methods, devices,and materials are described, although any methods and materials similaror equivalent to those described herein can be used in the practice ortesting of the invention.

The apparatus and methods of the invention provide for in vivo and exvivo control, detection and measurements of radiation therapy sourcesusing radiation detectors such as, for example, scintillating materialsuch as scintillating fibers, scintillating crystals, scintillatingliquids and scintillating gases. Embodiments of the invention includethe apparatus, the use of such apparatus, and methods during the courseof patient treatments.

Scintillating material such as fibers have functional properties thatconvert incident or induced gamma rays into visible light. When a gammaray photon hits a scintillating fiber, the fiber emits electrons throughCompton scattering or the photoelectric effect. As these electrons passthrough the scintillating fiber, atoms are excited to a higher state.Light is then emitted as the atom returns to ground state. Similarphenomenon occurs for an incident beam of electrons. The light may thenbe detected by a detector or photomultiplier tubes with the detectedlight intensity related to the amount of excitation caused by theradiation source.

FIG. 1 is a functional block diagram of an apparatus for characterizingradiation sources, generally denoted by reference numeral 100. An arrayof scintillating fibers 105 having a width “D”, includes fibers 1-n,each fiber having width “x”, which may be about 0.2 mm, may be usedex-vivo to characterize a radiation source 115 such as, for example, aniridium-192 seed. The scintillating fiber array 105, also known as anactive fiber array, may be coupled to an associated detector(s). Theterm “active” refers to being responsive to radiation such as emittinglight. The radiation source 115 is typically inserted into a radiationdelivery guide shown here as catheter 110, usually plastic, having adiameter of “Φ”, which may be sized approximate the width of the fiber,which in this example is about 0.2 mm. Of course, other structures maybe used as radiation delivery guides. Some examples of other suitablestructures are described below. The catheter 110 may be positioned nextto the scintillating fiber array 105 with the long axis of the catheter110 perpendicular to the long axis of the fibers 1-n of scintillatingfiber array 105. The radiation source 115 having length “L”, which maybe about 1 mm, is typically pushed through catheter 110, traversingwidth “D”, which may be about 30 cm, of the scintillating fiber array105. The dimensions indicated for “x”, “Φ”, “D” and “L” are exemplaryand may vary as necessary for particular applications.

FIG. 1 also illustrates the movement of the radiation source by showingthe same radiation source 115 in two different positions, although theradiation source typically has multiple positions as it is steppedacross the entire scintillating fiber array 105, which in someembodiments may be an array of other scintillating material. Theradiation source 115 may be pushed through the catheter 110 using adelivery system such as a conventional robotically controlled steppingmotors (i.e., robotic controller), for example, which may push thesource 115 across the array in predetermined increments. Examples ofsuch robotic controllers are GammaMed 2i, Nucletron Corporation'sSelectron and Varian Medical System's Vitesse HDR Brachytherapyafterloaders.

As the radiation source 115 traverses the scintillating array 105, thecharacteristics of the radiation source 115 and its directionalintensity may be measured by the photo detector 130. The photo detector130 may include photo detecting devices such as photomultiplier tubes,photodiodes, charge-coupled devices (CCDs), solid state photomultipliers(SSPMs), or other devices known in the art to detect the transmittedlight from the scintillating array 105 induced by the radiation source115.

In this way, the radiation source 115 may be characterized as to itsdirectionality and intensity in one or more dimensions and over thelength of the radiation source 115. Since the radiation source may havevariations in characteristics along its length, identifying thesevariations may now be captured as it moves across the fiber array 105.The unique radioactive properties of the radiation source 115 may thenbe captured by a computer for subsequent use in developing or executinga treatment plan using the characterized radiation source 115.

The photo detector 130 may be coupled, either permanently or detachably,to each fiber 1-n of the fiber array 105 or by optional light guides 125which may be securely restrained by restraint 120. Other techniques forcoupling scintillating fibers to a photo detector are known by thoseskilled in the art and which may be used in the invention. For example,photo detectors may be coupled to both ends of the fibers 1-n.

In other embodiments, another fiber array or arrays (not shown) may beemployed either in one or more planes such as above the catheter 110 andparallel to the fiber array 105 or in a pre-determined plane at an angleto the fiber array 105, to acquire intensity readings of radiationsource 115 in multiple orientations for mapping the distribution ofradiation from source 115. The distribution and intensity mapping may becaptured and recorded, perhaps automatically by computer, for use indevelopment of a treatment plan for a patient. Moreover, the radiationsource may be turned (i.e., rotated), typically about its long axis by aknown amount, and the characterization process repeated in order toascertain radiation properties in the new orientation. Thecharacterization of the radiation source may be recorded for later usein treatment planning and treatment application.

The fibers 1-n are typically sized to about 0.2 mm in diameter or width(but may vary), since fiber size determines, in part, spatialdistribution and provides for center-of-gravity type calculations of theradiation source 115. The fibers 1-n may have a square, elliptical orcircular cross section, and are often formed of a plastic scintillatingmaterial. One suitable type of commercially available scintillatingfiber that may be used in the invention is known as Bicron BCF-12.

The total width “D” of the fiber array 105 should be sufficient to testfor the radiation source 115 uniformity and to test for dwellingpositions. Often, in embodiments, “D” may be greater than or equal to100 L, however, length “D” may be any size that renders an effectivereading of dwelling positions for radiation source 115. The length “y”of the fibers 1-n should be greater than the diameter “Φ” of catheter110. Once the characterization of radiation source 115 has beendetermined, this information concerning the radiation source 115 may beused to construct a treatment regimen specific to a particular patientso that placement of the radiation source for producing predictableradiation dosages and directionality might be achieved during the courseof treatment.

Dwelling positions are positions where the source typically remainsstationary for some small period of time. During treatment the sourcestypically do not move continuously but step, dwell, step, dwell, etc.,as needed. So, there is greater radiation delivery at the dwellpositions even for a nominal uniform source. Accordingly, if dwellcharacteristics are known, both the source distribution and thedelivered source distribution can be obtained, according to theprinciples of the invention. Characterization typically refers to thespatial distribution of the intensity at the surface of the source andaway from the source (i.e., in the medium where the source is placed).For example, if a dose is prescribed to be delivered to certain area fortreatment, for instance, the characterization of the source permitsimproved dose delivery accuracy and also dose area distributionaccuracy.

In order to detect and measure actual radiation dosage during the courseof radiation therapy treatments, such as for tumors in the breast orprostate, for examples, an embodiment of a scintillating fiber array maybe employed in vivo as a detector array. A scintillating fiber array maybe configured to conform to the structure of a catheter, typicallycircular but may be any configuration according to the catheter, andeither embedded in the walls of the catheter or configured to line theinner (or even outer) surface of the catheter.

FIGS. 2A and 2B schematically illustrate embodiments of active cathetersof the invention. The active catheter or other implantable medicaldevice is capable of sensing radiation levels and delivering outputs toa photo detector. Referring to FIG. 2A, active catheter 200 may beconstructed with a plurality of scintillating fibers 205 embedded orotherwise arranged in the walls 210 of the catheter 200. The number ofscintillating fibers 205 may be such that they substantially encompassthe inner circumference of the catheter 200, however, a fewer number offibers may be employed. The length of scintillating fibers 205 may havea length substantially the same as the length of catheter 200, or thelength of the catheter that the source 115 traverses, but may be longeras necessary for connecting to a photo detector, for reasons describedbelow. The diameter or thickness of the scintillating fibers 205 may beas small as about 100 μm, or sized as necessary, to line thecircumference of the catheter 200 with multiple fibers, preferably fouror more fibers.

In other embodiments, some of which are described below in more detail,the catheter may be solely a radiation detector with one or morescintillating fibers, but without a shaft for receiving a radiationseed. This shaft-less catheter may be deployed in vivo as a detectormechanism. The shaft-less catheter may have smaller overall dimensionsas compared with a catheter configured with a shaft.

Optionally, optical fibers, light guides or wave guides may be attachedto the end of each scintillating fiber 205 to provide signals to a photodetector, photomultiplier or similar device while also permittingcontrolled insertion of a radiation source 115 into the inner chamber207. However, the scintillating fibers may be coupled to a photodetector directly. Examples of suitable photo detectors includephotomultipliers (PMT) from Hamamatsu such as the C8 multi-anode PMT andCentrovision series 5-T photodiodes.

Referring to FIG. 2B, the active catheter 215, has a plurality ofscintillating fibers 205 arranged into a substantially circular arraywhich may be constructed as an independent component and inserted intothe catheter 215 formed integrally with the inner circumference, oraffixed in any other manner known in the art. Preferably, if a smallnumber of scintillating fibers are employed, then the spacing should beevenly distributed. The circular array may be bonded and held in anessentially circular orientation by an appropriate flexible adhesive orby a thin adhesive faced backing. In other embodiments, the innersurface of the catheter may have sleeves along its length, or part ofits length, to receive removable or non-removable lengths ofscintillating fiber. Moreover, the plurality of scintillating fibers 205may be embedded in the walls of the active catheter 215, perhapssubstantially equally spaced about the circumference of the activecatheter 215.

As noted above, the diameter or thickness of the scintillating fibers205 may be as small as about 100 μm, or sized as necessary, to line, atleast partially, the circumference of the catheter 200 with multiplefibers, preferably four or more fibers. The shape of the scintillatingfibers may be essentially any shape including circular, elliptical,square, etc. Optional photo or wave guides 125, as shown in FIG. 2B, maybe attached to the end of each scintillating fiber 215 to providesignals to a photo detector or photomultiplier 130 while also permittingcontrolled insertion of a radiation source 115 into the inner chamber212. The fiber 205 may be coupled directly to a photo detector withoutthe use of a light or wave guide.

The radiation source 115 may be inserted into a receptacle of thecatheter 215 and controlled via a lead 225 by a conventional roboticstepping motor apparatus 220. The stepping control lead 225 and optionalwave guides 125 may be combined into a common harness and attachmentassembly for ease of use. The robotic controller 220 provides steppingmovement of the radiation source 115 in predetermined increments,according to pre-determined programming. Further, in some embodiments,the robotic controller 220, under suitable program control, may providerotational control of the radiation source 115 to alter its orientationabout its longitudinal axis (during stepping and/or when stopped).

Further shown in FIG. 2B is a data acquisition system (DAQ) 227 forreceiving outputs from the photo detector 130 and for interacting withthe robotic controller 220 such as for receiving outputs and/or forcontrolling the robotic controller. The DAQ 227 may also provide datastorage, display components and computational processing, such asBracytherapy Dose Monte Carlo algorithms to reconstruct appliedradiation by projecting a dose map, as described below.

FIG. 2C is an embodiment of a radiation detector constructed as ascintillating fiber with an optional housing, according to principles ofthe invention. The radiation detector 230 is formed by scintillatingmaterial 206 encased in an optional housing 230 that provides eitherflexible protection or rigid protection to the scintillating material206 and/or permits the scintillating material to be implantable in vivo,e.g., in a manner similar to the active catheter embodiments describedabove. The scintillating material 206 may be a scintillating fiber andmay be suitable for in vivo use without any encasing structure such asthe housing 230. Moreover, the scintillating material 206 may beoperatively coupled to a photo detector 130.

FIG. 2D is another embodiment of a radiation detector made of solid,liquid or gaseous scintillating material, according to principles of theinvention. The radiation detector 232 is formed from a scintillatingmaterial such as, for example, scintillating gas (with an encasementencasing the gas), scintillating crystals, scintillating liquid (with anencasement encasing the liquid) or other scintillating solid. Theradiation detector 232 may be implantable in vivo, like the activecatheter embodiments, and may be operatively coupled 234 to a photodetector 130.

FIG. 2E is yet another embodiment of a radiation detector havingscintillating material at its tip, which shows its use in characterizinga radiation source, according to principles of the invention. Theradiation detector 240 has an end portion 235 including scintillatingmaterial coupled to an optical fiber 207 (or, alternatively, a lightguide) which is connectable to a photo detector 130. In alternateembodiments, the scintillating material may be directly coupled to aphoto detector. This radiation detector 240 may be somewhat morediscriminating as a detector since only the tip of the detector isresponsive to radiation 250. Further, the radiation detector 240 may beemployed to characterize a radiation source 115 by moving a radiationsource 115 in a perpendicular direction to the detector 240.Alternatively, the detector 240 may be moved while the radiation sourceis stationary. In this way, the radiation source 115 may becharacterized in a manner similar to the manner described in relation toFIG. 1. The radiation detector 240 may also be implantable in vivo tomeasure radiation levels during treatments. Furthermore, the radiationsource 115 may be characterized in a similar fashion using the radiationdetector embodiment of FIG. 2C, which has a single scintillating fiber.For example, the scintillating fiber detector of FIG. 2C may be orientedwith the end of the scintillating fiber towards the radiation source(i.e., perpendicular to the radiation source in a similar manner to thatshown in FIG. 2E) and to characterize the radiation source by movingeither the scintillating fiber or the radiation seed.

FIG. 2F is an illustration showing how the radiation detector of FIG. 2Emay be used to detect radiation in vivo, according to principles of theinvention. FIG. 2F shows the radiation detector 240 having ascintillating material end portion 235 and optical fiber 207 connectedto a photo detector 130. When placed in vivo near a tumor 245, thedetector 240 detects radiation 250 such as emitted by a radiation source115. The radiation source 115 may be placed in vivo by the activecatheters of FIGS. 2A and 2B, for example. The radiation detector 240then detects a level of radiation 250, which may be attenuated by thetumor 245. The level of light measured by the photo detector 130 isindicative of radiation levels detected at the end portion 235, whichmay then be used to reconstruct or confirm actual applied radiationdosage during a treatment, as discussed below. Of course, multipleradiation detectors 240 might be employed simultaneously in vivo inorder to construct a more detailed dosage map as a result of atreatment. In alternate embodiments, a fiber optic 207 and thescintillating materials 235 may be constructed so that the combinationof the two forms a radiation detector without any other outer structure.

FIG. 3 illustrates use of an active catheter of the invention in abiological system, generally denoted as reference numeral 300.Biological system 300, which may be a part of a subject such as a humanor an animal, is shown with a tumor or plaque mass 310 requiringradiation therapy treatment. The active catheter 200 (or, alternatively,215) may be implanted in a biological system 300 to irradiate the tumor310 according to a pre-determined radiation treatment plan based onradiation source 115 characteristics, as determined in accordance withthe principles explained with reference to FIG. 1, for example. Theradiation treatment plan may occur over the course of severaltreatments, perhaps over days or weeks. The placement of the activecatheter 200 into the biological system 305 facilitates measuring dataof actual radiation dosage applied.

The scintillating fibers 205 used in FIG. 3 may have a width “x”different from height “r”. The diameter “Φ” must be sufficiently largeas to receive the radiation source 115 and robotic stepper control lead225 in order to move the radiation source along the length of the activecatheter 200, or the guide path therein. A photo detector and steppingcontroller are not shown in FIG. 3, but are typically present, aspreviously discussed in relation to FIG. 2B.

The robot stepping controller (e.g., 220) is usually calibrated so thatthe beginning position (one end of active catheter 200) of the radiationsource 115 is known, as well as the total length to traverse in theactive catheter 200. As the stepping controller 220 moves the radiationsource through the active catheter 200, the position may be constantlycalculated, or derived from known techniques, since the distance perstep is known.

However, the nature of the active catheter 200 may also provide anotherfeature, i.e., it may function as a calibration and tracking mechanismto assure the location of the radiation source 115 during its transitthrough the active catheter 200, in addition to its function ofdetecting the dosage emitted by the radiation source 115. As theradiation source 115 traverses active catheter 200 under control of therobotic controller, each of the scintillating fibers 205 senses theemission of radiation and generates light in proportion to the intensityof the radiation, with the signal at the photo detector weakening withdistance from the source in a calibratable and repeatable way.

However, as the radiation source 115 moves along the catheter 200, theapparent intensity of the generated light in each fiber diminishes sincethe light must traverse greater distances through the scintillatingfibers to reach a photo detector that is typically coupled to each endof the scintillating fibers 205, i.e., effectively attenuating the lightsignal. This attenuation rate or level is related to the distancetraversed by the radiation source 115 in the active catheter 200 and,when calculated, should substantially match with a current positionknown by the robotic controller 220, typically based on pre-determinedsteps or increments. If a discrepancy occurs between positions ascalculated and established by the robotic stepping motor as comparedwith calculated positions based on the scintillating fiber(s) lightlevels, corrective action may be warranted, perhaps even suspension oftreatment. This constant feedback loop and cross-verification betweenthe two location tracking techniques provides added integrity and safetymargins to therapy treatment sessions.

As the radiation source 115 traverses the active catheter 200, theintensity of the radiation emitted at any point along the activecatheter 200 may also be detected and computed since each scintillatingfiber emits light in proportion to the radiation intensity impactingeach fiber. This information may be recorded for later simulation tore-create an overall three-dimensional exposure and dosage map of theaffected site. Over the course of several treatments, an accumulativedosage map may be generated, perhaps from several radiation detectors,which may provide a basis for adjusting directionality or dosage levelsin order to achieve a pre-determined exposure plan of the tumor areaunder treatment.

Moreover, the dwelling of the radiation source 115 may be corroboratedwith the robotic stepping controller in real-time to assure thatradiation exposure times, hence radiation dose, at any given locationalong the active catheter 200 is being applied according to thepre-determined treatment plan. In some embodiments, a computercontroller (not shown) may be employed to accept outputs from the activecatheter 200 (and/or associated photo detector), to process the outputsfor generating dosage mapping and to alter and/or control the actions ofthe robotic controller 220, when necessary, to achieve changes to thetreatment, perhaps dynamically.

Generally, known Monte Carlo code (i.e., software and algorithms)describes the interaction of radiation with matter. Because theseinteractions are probabilistic in nature, a significant number ofinteractions are usually simulated to obtain the most likely set ofinteractions for any specific circumstance. Hence, the term “MonteCarlo.”

There are two distinct Monte Carlos employed directly or indirectly bythe invention. The first is based upon the commercially availableprograms used commonly for radiation treatment planning. For example, aphysician specifies an amount of radiation needed and location and themedical physicist runs this type of Monte Carlo, which simulates thepatient dosage. This treatment planning simulation typically requirespatient data input such as from a computed tomography (CT) scan, or thelike, as well as input describing the radiation source to be used (e.g.,external beam, brachytherapy seed, brachytherapy HDR source, etc.) andits characteristics. Examples of this “treatment planning” type ofcommercially available Monte Carlo packages include Varian's Eclipse orBrachyvision products.

Another type of Monte Carlo, referred to as the “Brachytherapy DoseMonte Carlo,” is provided by the invention. The Brachytherapy Dose MonteCarlo is based on the commonly available tool kit, GEANT4, from CERN(European Laboratory for Particle Physics, Geneva, Switzerland) andprovides, in part, fast processing for removing the physics processes inthe data acquisition such as, for example, data obtained from theoutputs of the scintillating detectors of the invention during atreatment. The Brachytherapy Dose Monte Carlo may be used to take intoaccount any radiation scattering during the treatment so that improvedimage resolution of the measurements might be achieved. TheBrachytherapy Dose Monte Carlo also provides a projected dose map withina given area (e.g., to track events back in time). The projected dosemap may then be feedback (as input) to the treatment planning MonteCarlo for treatment alterations. The Brachytherapy Dose Monte Carlo mayalso simulate treatment planning for verification or other purposes.

FIG. 4 illustrates a system showing the use of a plurality of activecatheters of the invention for treating a tumor, generally denoted byreference numeral 400. The system 400 is used to treat a body part 405and a tumor 415 to be treated by radiation therapy. A plurality ofactive catheters 200 a-200 e is implanted in a pre-determinedorientation in relation to the tumor 415 in anticipation of bothapplying radiation treatment and also for measuring the actual radiationdosage applied. Any number of active catheters may be employed in anyappropriate orientation as deemed appropriate for an intended treatmentplan. The location and orientation of the active catheters 200 may bepre-determined by simulation in order to achieve a desired radiationdistribution and/or dosage levels deemed appropriate to the diagnosis.The orientation may also be based, at least in part, on thecharacteristics of a chosen characterized radiation source or sources.The active catheter orientation (and distance relationships) may beconfirmed by X-ray or other imaging technique. The same radiation sourceor other radiation sources may be used simultaneously or serially in oneor more of the active catheters 200, as necessary.

In the illustrative example of FIG. 4, one active catheter 200 afacilitates delivery of a radiation source (e.g., characterizedradiation source 115 of FIG. 1 or 2E) via a combined assembly 420. Thecombined assembly 420 is configured to permit a stepping robot lead 425to insert a radiation source into the active catheter 200 while alsopermitting the output of the active catheter's 200 a scintillatingfibers (within the active catheter 200 a) to traverse the one or moreoptional light or wave guides 430 to a photo multiplier or otherdetector (not shown). The one or more optional light or wave guides 430may be functionally connected to one or more scintillating fibers withinactive catheter 200. The optional light or wave guides 430 may be apre-fabricated assembly of multiple wave guides for ease of use. Acoupler 435 may also be employed for attaching a robotic controller 425.In some embodiments, the scintillating fibers may be coupled directly toa photo detector without use of the light or wave guide. Moreover, thephoto detector and/or robotic controller may be interfaced with a dataacquisition system (e.g., DAQ 227 of FIG. 2B)

As the radiation source 115 enters active catheter 200 a, asynchronization of the stepping robotic controller and the scintillatingfiber output from the active catheter 200 a may be performed. In thismanner, a cross-check of actual location of the radiation source may beachieved throughout its traversal of the active catheter 200 a, aspreviously described. Further, a baseline reading from each activecatheter 200 b-200 e, and each scintillating fiber therein, may also beestablished.

As the radiation source 115 traverses the active catheter 200 accordingto a pre-determined treatment plan that projects an intended dosageamount, each active catheter 200 a-200 e responds to the effects of theradiation source 115. Each active catheter's 200 a-200 e response levelis dependent on its relationship to the radiation source 115. Of course,active catheter 200 a typically responds with an indication of greatestintensity (i.e., greater light level than the other catheters) since theradiation source 115 is in closest proximity by being in catheter 200 a.However, based on orientation and distance, each of the other activecatheters 200 b-200 e also supplies an indication of radiation levels(i.e., light levels) which are propagated to a photo detector.

As a treatment progresses, the real-time dose distribution readings fromeach active catheter may be captured and processed by a data acquisitionsystem (such as DAQ 227 of FIG. 2B) including Brachytherapy Dose MonteCarlo simulation, or similar techniques, to compare against a forecastedexpectation. In some embodiments, the data acquisition system may alsoreceive outputs from the robotic controller and may control theoperation of the robotic controller based on real-time events. Theactive catheters 200 a-200 e provide actual measurements of dosagelevels applied to the tumor 415 and the surrounding tissue areas. Thismeasurement provides a greater degree of confidence that a treatment isdelivering or has delivered the expected amount of radiation to a siteand provides a basis for adjusting subsequent applications as neededover time to achieve the goals of the treatment plan.

The total dose (i.e., total integrated signal) from each catheterdetermines the total dose seen at a given location (i.e., an activecatheter). Knowing the fiber locations inside a patient plus the totaldose gives information for 2-dimensional or 3-dimensional dose maps whencombining all fibers (which depends on the number of active cathetersemployed).

If necessary, an additional active catheter 200 may be used insubsequent treatments, or a re-positioning of an active catheter 200 maybe warranted based on measured results. Moreover, the radiation source115 may be applied in any of the active catheters 200, in any order,including simultaneously using additional radiation sources, to achievea desired overall radiation treatment effect. In other embodiments, theradiation source may also be turned/rotated by the robotic controller tocontrol directionality of the radiation emission.

FIGS. 5A-5F are graphs, with each graph illustratively representative ofradiation detected by a separate active catheter from among six activecatheters that could be employed during a treatment, such as catheters200 a-200 e of FIG. 4. FIG. 5A corresponds to a first active catheterused in a treatment; FIG. 5B corresponds to a second active catheterused in a treatment, and likewise for FIGS. 5C through 5F whichcorrespond to active catheters three through six.

The y-axis denotes radiation levels, for example in curies, andrepresents the number of photons collected by the photo detector (e.g.,PMT). The x-axis denotes energy in MeV (million electron volts). Eachgraph, for each active catheter, shows two traces. The first trace showsthe dosage detected at the corresponding active catheter, prior to anycorrection applied to a treatment plan (e.g., after a first radiationtreatment). The information from the first trace (i.e., data from thecorresponding active catheter), may be processed by Brachytherapy DoseMonte Carlo simulation or similar simulation in order to correct forphysics processes of the treatment. The first trace is indicative ofintensity, from the corresponding active catheter's position, of thereal-time patient dose, prior to correction.

The Brachytherapy Dose Monte Carlo simulation algorithm uses, at leastminimally, relevant physics processes such as Compton scattering, andsufficient speed to produce timely results, for example, in a fewminutes, perhaps faster. The Brachytherapy Dose Monte Carlo simulationproduces accuracy in location and geometric information of the dosagesource, typically accurate to within a few millimeters. Using the datafrom the multiple active catheters, the Brachytherapy Dose Monte Carlosimulation forms a volumetric dose distribution effectively producing aradiation map. This dose distribution may be used to both monitorpatient dose and as input in real time to alter treatment progress andplanning.

Trace 2 of each FIG. 5A through 5F illustratively represents the energydistribution of the particles emitted from the source at the surface ofthe source which provides information on what has been emitted by thesource effectively. The trace information may also be used toextrapolate the dose within the patient (after correcting for energyloss and taking into account secondary particles produced).

Based on Brachytherapy Dose Monte Carlo simulation, it may be deemedappropriate to increase a dwell location time period of the radiationsource in one or more of the active catheters to achieve an increase (oralternatively, a decrease) in applied radiation dosage in a particulardimension or dimensions. This may translate into the increase (ordecrease) in total radiation at a specific site, typically the tumorunder treatment, but may also alter delivered dosage to surroundingtissue, as desired.

Real-time capturing or collecting of the active catheter outputs andrapid processing of the detected radiation levels (i.e., correspondinglight levels) by the acquisition system (DAQ) provides a rapid feedbacktool to radiologists or doctors to authenticate actual dosage levelsdelivered for a treatment. The fast DAQ system typically includesdedicated algorithms to analyze and present data collected and includescode that converts collected signals to effective dose at the surface ofeach fiber (or scintillating material). The DAQ system may also performthe Brachytherapy Dose Monte Carlo reconstruction simulations. Bycomparing a pre-determined treatment plan and its projected radiationdistribution to the real-time data acquisition system generated fromactual measured radiation levels, a basis is now available to modifyplacements of the active catheters, change dwelling times/rate of theradiation source movement or change orientations of the radiationsource, as necessary, to either decrease or increase radiation levels ordirectionality of the radiation.

FIG. 6A is a diagram of an active mammosite catheter, generally denotedby reference numeral 615. The active mammosite catheter 615 includes oneor more scintillating fibers 205 (the scintillator) arranged along thelength of the shaft of the active mammosite catheter 615. Thescintillating fibers may be embedded in the walls of the activemammosite catheter 615. The active mammosite catheter 615 also comprisesan expandable balloon 610 connected to an end section of the activemammosite catheter 615.

The active mammosite catheter 615 further comprises a coupling section620 for coupling to a liquid supply for expanding the balloon 610, foroperatively connecting to a robotic controller (not shown) for insertinga radiation source (not shown) and for operatively connecting thescintillating fibers 205 to a photo detector (not shown) for detectinglight levels emitted by the scintillating fibers 205 when exposed to aradiation source. The scintillating fibers 205 detect radiation signalsfrom the radioactive source when inserted, with a change in signal sizedependent on the location within the shaft of the radioactive source.Moreover, signals from the radioactive source within the balloon aresimilarly reconstructable as a function of distance from thescintillator.

FIG. 6B is an illustrative diagram showing the use of an activemammosite catheter of the invention. As illustrated, a lumpectomy cavity605, created when a tumor is removed by lumpectomy, is treated with HDRusing an active mammosite catheter or mammosite delivery device.

The active mammosite catheter 615 includes expandable balloon 610, showninserted into a lumpectomy cavity 605. The active mammosite catheter 615provides delivery of a radiation source 115 through the shaft of theactive mammosite catheter 615 into the balloon area, when inflated by asaline solution, for expansion of the attached balloon 610 in cavity605. The active mammosite catheter 615 outputs, from the scintillatingfibers within the active mammosite catheter 615, may be coupled to acorresponding photo detector, as discussed previously in reference toFIG. 2B. A robotic controller lead 620 provides for insertion control ofthe radiation source 115 and controls pre-determined stepping motion ofthe radiation source 115. Since the radiation source 115 is insertablethrough the shaft of the active mammosite catheter 615 to an area withinthe balloon 610, radiation is delivered to the area where cancer is mostlikely to recur, the surrounding tissue forming the cavity 605. Theactive mammosite catheter 615 provides for measuring actual radiationdosage applied, perhaps over multiple treatments. A multi-dimensionaldosage map may be created from the output of the scintillator of theactive catheter by use of the data acquisition system, for example.

The principles of the invention may also be employed in permanent seedimplantation procedures since knowing the dose distribution within apatient prior to releasing the seed into the body provides physicianswith the ability to modify the dose. For example, by monitoring theradiation source within a catheter or other delivery device being usedduring implantation prior to the source reaching the end of the deviceenables the physician to modify placement or dose, as appropriate.

Also, a seed implantation gun may also be employed as the deliverydevice in therapy seed implantation. The implantation gun may alsoinclude scintillating radiation detection materials arranged andconfigured according to principles of the invention.

FIG. 7 is a flow diagram of an embodiment showing process steps of usingan embodiment of the invention, beginning at step 700. FIG. 7 and allother flow diagrams herein may equally represent a high-level blockdiagram of components of the invention implementing the steps thereof.The steps of FIG. 7 may be implemented on computer program code incombination with the appropriate hardware. This computer program codemay be stored on storage media such as a diskette, hard disk, CD-ROM,DVD-ROM or tape, as well as a memory storage device or collection ofmemory storage devices such as read-only memory (ROM) or random accessmemory (RAM). Further, the computer code may also be embodied, at leastin part, in a medium such as a carrier wave, which can be extracted andprocessed by a computer. Additionally, the computer program code and anyassociated parametric data can be transferred to a workstation over theInternet or some other type of network, perhaps encrypted, using abrowser and/or using a carrier wave.

Continuing at step 705, one or more radiation source(s) may becharacterized which may include the use of scintillating materialradiation detectors. At step 710, a treatment plan may be developed toadminister radiation, typically based in part on data from thecharacterized radiation source(s). At step 715, one or more activecatheters guides or other radiation delivery devices may be deployedalong with any other radiation detector(s) according to the treatmentplan. The configuration of the active catheters and/or radiationdetectors may be confirmed by imaging techniques such as x-rays. At step720, the treatment may be monitored in real-time by a data acquisitionsystem which acquires outputs from the active catheter(s) and/orradiation detectors. At step 725, the outputs from the active cathetersand/or detectors may be processed in real-time to account for physics ofthe treatment and to provide feedback on measured radiation levels tothe physicians or technicians overseeing the treatment.

At step 730, a dosage map may be generated to show a two or threedimensional view of administered radiation. At step 735, an evaluationof measured dosage during treatment against expectations of thetreatment plan may be made. This may be performed automatically bycomputer or by visual evaluation by the physicians or technicians. Atstep 740, the treatment may be adjusted as necessary to modify dosagelevels which may include altering directionality or dwelling times, forexample. This may be done automatically by computer control or byintervention by a physician or technician, depending on the nature ofthe necessary adjustments. At step 745, a check is made whether thetreatment is finished which may depend on meeting the treatment plangoals or perhaps based on unexpected measured levels, for example. Ifthe treatment is deemed finished, the process ends at step 750;otherwise, the treatment continues at step 720.

FIG. 8 is a diagram of an embodiment for external beam qualityassurance, configured according to principles of the invention. A beamdelivery system or apparatus 805 such as an external beam deliveryapparatus may impart a beam of particles 810, such as photon, electron,proton, ion or hadron particles, upon a scintillating material 815 arraywhich may comprise scintillating fibers for example, as a beam spot 820,that may pass through 825 the scintillating material 815. Thescintillating material may generate signals in a beam's presence forproviding a basis to calibrate the configuration, pattern and/orintensity of the incident beam 810.

In another aspect, the scintillating material 820 may be arranged as aplurality of arrays in two or more dimensions to form a combined arrayfor achieving dose measurements at a point or plurality of points on thecombined arrays. For example, but not limiting to this configuration,two fiber arrays may be arranged adjacent but the fibers in eachadjacent array being perpendicular to one another (see, e.g.,arrangement shown in FIG. 9B) so that a beam intensity measurement atone or more x-y locations may be acquired.

FIG. 9A is an illustration of a radiation detector scheme configured topermit determination of a dose, configured according to principles ofthe invention, generally denoted by reference numeral 900. A pluralityof detectors 905 a, 905 b, 905 c, which may be optical fibers withscintillating material 910 a, 910 b, 910 c at one end of the respectivedetectors 905 a, 905 b, 905 c for example, may be arranged proximate toeach other so that they are at different relative lengths respective toone another, or at least the scintillating material 910 a, 910 b, 910 cmay be positioned at known relative locations from one another. Thisdetector scheme 900 may be an array of detectors preconfigured withpredetermined relative positions to one another, perhaps as a unifiedarray of detectors held in fixed relationship to one another. Thedetectors 905 a, 905 b, 905 c may be configured to be coupled to one ormore photo detectors (not shown). When used in vivo, the level ofradiation detected by each detector 905 a, 905 b, 905 c may be used todetermine a dosage amount at a given location(s), and/or may be used todevelop a dosage map. In yet another configuration, the scintillatingmaterial 910 a, 910 b and 910 c may be configured so that a dosageamount and/or location may be determined by subtracting levels from twoscintillating material devices of differing lengths.

FIG. 9B is an illustration of an embodiment of radiation detectorsconfigured to permit determination of a radiation dose or to mapradiation, according to principles of the invention, generally denotedby reference numeral 920. A plurality of radiation detectors 925 may bearranged in the y-axis (1-n) and a plurality of radiation detectors 925may be arranged in the x-axis (1-m) as shown. The plurality of radiationdetectors 925 may comprise scintillating material and configured to beconnectable to photo detectors. The 2-dimensional aspect of thisconfiguration provides for determination of a radiation dose or to mapradiation, since radiation levels may be associated with one or moreparticular x-y intersections. In another aspect, another set ofdetectors may be arranged in a z-axis (1-n) to provide a 3-dimensionaldetector. At least one first signal from a first subset of detectors inone axis and at least one second signal from a second subset ofdetectors in another axis (and optionally at least one third signal froma third subset of detectors in yet another axis) may provide a basis forproducing a radiation map. The first subset of detectors and the secondsubset of detectors, and optionally a third subset of detectors, may beconfigured at an angle from one another. In one aspect the angle may beabout ninety degrees, however, other angles may be employed.

FIG. 10 is an exemplary schematic of a positioning balloon with one ormore scintillating fibers as an in-vivo or ex-vivo dosimetry for qualitymonitoring, according to principles of the invention. An exemplary bodylocation 1005, such as a pelvic area or thorax area, may encompass atumor 1010 (perhaps related to a body organ like a prostate, forexample). A positioning balloon 1015, commonly employed in surgicalprocedures, may be used to position one or more scintillating detectors1020 such as scintillating fibers so that the scintillating detectors1020 may be positioned in a desired location relative to the tumor toreceive radiation for treatment or imaging. In this way, the radiationtarget, i.e., tumor 1010, may be held in mutual relative location withthe scintillating detectors 1020, for receiving of external radiationtreatment, for example.

FIG. 11A is an exemplary embodiment of a flexible radiation detector,configured according to principles of the invention, generally denotedby reference numeral 1100. The flexible radiation detector 1100comprises a catheter portion 1105 with a hollow portion 1110 (areceptacle) running along the length of the catheter portion 1105,providing essentially an enhanced balloon or similar catheter. Aflexible or semi-rigid balloon portion 1115 attached at one end of thecatheter portion 1105 may expand during a procedure perhaps using salinesolution, for example. One or more scintillating fibers 1120 may bearranged within or upon the wall of the balloon portion 1115 andconfigured to conform to the contour of the balloon portion 1115 whenexpanded. The one or more scintillating fibers 1120 may be connected toa photo detector, perhaps via one or more connecting portions 1112running along the catheter portion 1105. A radiation source 1113 may beinserted into the catheter portion 1105 into the balloon portion 1115during treatment or imaging procedures, while the scintillating fibers1120 may detect radiation levels/dosage during such treatment or imagingprocedure, the principles described previously.

FIG. 11B is an exemplary embodiment of a flexible radiation detector,configured according to principles of the invention, generally denotedby reference numeral 1102. In this embodiments 1102, a second balloonportion 1155 may be configured inside of an outer balloon portion 1150.Scintillating material 1152 (e.g., liquid, solid or gas) may becontained within the two balloon portions 1150, 1155. Connecting portion1112 may convey signals emitted by the scintillating material 1152 alongthe catheter portion 1105 to a photo detector. A radiation source 1113may be inserted into the catheter portion 1105 to provide radiationtreatment or, alternatively, an external beam delivery system (such asin reference to FIG. 8) could deliver the radiation beam, while thescintillating material 1152 provides dosage level signals. Moreover, inone aspect, any of the at least one balloon portion, e.g., portions1150, 1155, may include the arrangement of FIG. 11A, i.e., scintillatingmaterials arranged along the surface of, or embedded within, the balloonportion. In one aspect, the scintillating material 1152 may beconfigured into specific known partitions so that the signals from thepartitions may be correlated to specific regions of the balloon portion.

Any of the scintillating radiation detectors described herein may beused to detect and measure dose from external beam or any otherradiation therapy delivery system. The scintillating radiation detectorsdescribed herein may be used to measure dose from imaging devices, suchas x-rays, CT scans, fluoroscopy, positron emission tomography (PET),CT, single photon emission computed tomography (SPECT), diagnosticscans, cardiac, for example. The scintillating detectors herein may alsobe used to measure a dose from beam delivery systems (imaging,radiotherapy and the like). To accomplish the above, the scintillatingdetectors may be placed externally (on the skin or an immobilizationdevice, for instance) or internally (in a positioning balloon orcatheter, for instance). The scintillation radiation detectors may alsobe used for beam profile checks such as for calibrating beam shapesand/or intensity ex vivo for external beam imaging devices. Any of thescintillating radiation detectors described herein may be used to altera treatment plan.

For dosimeter detectors comprising scintillating fibers, signaldegradation along the fiber length may be used to ascertain a positionand/or directionality of the detected radiation. Here, in this example,smaller signals correspond, in a calculable way, to longer distance oftravel along the fiber and, hence, position. Alternatively, by using asubtraction technique involving for instance two coupled fibers ofslightly different lengths, a dose at a small or defined region may becalculated by subtracting the (possibly integrated) signal from theshorter from the signal from the longer, hence isolating the remainingsubtracted dose to that deposited in the spatial region of fiber lengthdifference. The dose evaluated would then be for the (presumably small)region of differing length only.

The external radiation types herein may include radiation related totreatment x-rays, electron beams, hadron beams, and the like, as well asto diagnostic modalities such as x-ray fluoroscopy, molecular imagingscans, SPECT, CT scans, and the like.

Various modifications and variations of the described methods andsystems of the invention will be apparent to those skilled in the artwithout departing from the scope and spirit of the invention. Althoughthe invention has been described in connection with specific preferredembodiments, it should be understood that the invention as claimedshould not be unduly limited to such specific embodiments. Indeed,various modifications of the described modes for carrying out theinvention which are obvious to those skilled in the art are intended tobe within the scope of the following claims.

What is claimed:
 1. A radiation detector comprising: a catheterconfigured with a hollow portion extending along a length of thecatheter and configured with at least one expandable portion; andscintillating material, wherein the scintillating material is arrangedin a continuous manner along a perimeter of a wall of the at least oneexpandable portion or arranged along a length of the hollow portion froma location within the expandable portion to a location outside of theexpandable portion, the scintillating material configured to be coupledto a photo detector for detecting incident levels of radiation in atherapy procedure, wherein the scintillating material comprises only oneof: a scintillating gas, a scintillating liquid and a scintillatingsolid.
 2. The radiation detector of claim 1, wherein the at least oneexpandable portion comprises a plurality of expandable portions, with atleast one expandable portion configured within another expandableportion.
 3. The radiation detector of claim 1, wherein the scintillatingmaterial comprises one or more scintillating fibers arranged along thesurface of, or embedded within, at least one balloon portion.
 4. Theradiation detector of claim 1, wherein the hollow portion extends intothe at least one expandable portion.
 5. The radiation detector of claim1, the hollow portion is configured to receive a radiation source. 6.The radiation detector of claim 5, wherein the scintillating materialprovides dosage level signals indicative of radiation from the radiationsource.
 7. The radiation detector of claim 1, further comprising thephoto detector.
 8. The radiation detector of claim 1, wherein thescintillating material is configured to conform to the contour of the atleast one expandable portion, when expanded.
 9. A radiation detectorcomprising: an array of scintillating fibers to detect incident levelsof radiation, the array configured to be insertable into a medicaldevice, wherein the medical device is configured to be insertable into apatient for a medical procedure, and wherein each scintillating fiber ofthe array is configured to be individually coupled directly to adetector for measuring incident levels of radiation.
 10. The radiationdetector of claim 9, wherein the array of scintillating fibers is anindependent component insertable into a catheter.
 11. The radiationdetector of claim 9, wherein the array of scintillation fibers isarranged to permit passage of a radiation source to be moved along thearray.
 12. The radiation detector of claim 11, wherein the array isconfigured as a circular array.
 13. The radiation detector of claim 9,wherein the array of scintillation fibers is configured as a circulararray to permit movement of a radiation source therewithin.
 14. Theradiation detector of claim 9, wherein the array of scintillation fiberscomprises an independent component and the array comprises a pluralityof individual fibers, wherein one or more individual fibers areremovable.
 15. The radiation detector of claim 9, wherein the array ofscintillation fibers is arranged within an expandable balloon.
 16. Theradiation detector of claim 9, wherein the array of scintillation fibersis connectable to a detector for measuring incident levels of radiation.17. The radiation detector of claim 9, wherein the medical devicecomprises a catheter.
 18. The radiation detector of claim 1, wherein thescintillating material arranged in the continuous manner along aperimeter of a wall of the at least one expandable portion is arrangedso that the scintillating material has a curved shape about thecatheter, when the expandable portion is in the expanded state.
 19. Aradiation detector comprising: an array of scintillating fibers todetect incident levels of radiation, the array configured to beinsertable into a medical device, wherein the medical device isconfigured to be insertable into a patient for a medical procedure,wherein the array of scintillation fibers is arranged to permit passageof a radiation source to be moved along the array.
 20. The radiationdetector of claim 19, wherein the array is configured as a circulararray.
 21. A radiation detector comprising: an array of scintillatingfibers to detect incident levels of radiation, the array configured tobe insertable into a medical device, wherein the medical device isconfigured to be insertable into a patient for a medical procedure,wherein the array of scintillation fibers is configured as a circulararray to permit movement of a radiation source therewithin.
 22. Aradiation detector comprising: an array of scintillating fibers todetect incident levels of radiation, the array configured to beinsertable into a medical device, wherein the medical device isconfigured to be insertable into a patient for a medical procedure,wherein the array of scintillation fibers comprises an independentcomponent and the array comprises a plurality of individual fibers,wherein one or more individual fibers are removable.
 23. A radiationdetector comprising: an array of scintillating fibers to detect incidentlevels of radiation, the array configured to be insertable into amedical device, wherein the medical device is configured to beinsertable into a patient for a medical procedure, wherein the array ofscintillation fibers is arranged within an expandable balloon.